0001437749-22-015938.txt : 20220627
0001437749-22-015938.hdr.sgml : 20220627
20220627084404
ACCESSION NUMBER: 0001437749-22-015938
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20220615
FILED AS OF DATE: 20220627
DATE AS OF CHANGE: 20220627
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jacob Jeffrey E.
CENTRAL INDEX KEY: 0001934189
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39468
FILM NUMBER: 221041659
MAIL ADDRESS:
STREET 1: 712 VISTA BLVD #305
CITY: WACONIA
STATE: MN
ZIP: 55387
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Panbela Therapeutics, Inc.
CENTRAL INDEX KEY: 0001029125
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 870543922
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 712 VISTA BLVD #305
CITY: WACONIA
STATE: MN
ZIP: 55387
BUSINESS PHONE: 9524791196
MAIL ADDRESS:
STREET 1: 712 VISTA BLVD #305
CITY: WACONIA
STATE: MN
ZIP: 55387
FORMER COMPANY:
FORMER CONFORMED NAME: Sun BioPharma, Inc.
DATE OF NAME CHANGE: 20150911
FORMER COMPANY:
FORMER CONFORMED NAME: Cimarron Medical, Inc.
DATE OF NAME CHANGE: 20150602
FORMER COMPANY:
FORMER CONFORMED NAME: CIMARRON SOFTWARE INC
DATE OF NAME CHANGE: 19961217
3
1
rdgdoc.xml
FORM 3
X0206
3
2022-06-15
0
0001029125
Panbela Therapeutics, Inc.
PBLA
0001934189
Jacob Jeffrey E.
712 VISTA BLVD #305
WACONIA
MN
55387
1
Common Stock
261931
D
Common Stock
17771
I
Jointly with spouse
Common Stock
54374
I
By trust
Stock Option (right to buy)
1.2400
2022-09-26
Common Stock
41766
D
Stock Option (right to buy)
1.4700
2022-09-26
Common Stock
35543
D
Stock Option (right to buy)
0.2200
2030-12-28
Common Stock
91523
D
Stock Option (right to buy)
0.2200
2030-12-28
Common Stock
177715
D
Warrants (right to buy)
5.6300
2023-02-01
Common Stock
5174
I
By trust
Fully vested.
Exhibit List: Power for Attorney EX-24
/s/ Joshua L. Colburn, Attorney-in-Fact
2022-06-25
EX-24
2
jacobpoa.txt
POWER OF ATTORNEY
EX-24
I, Jeffrey E. Jacob hereby authorize and designate each of Jennifer K.
Simpson, Susan Horvath, W. Morgan Burns, Joshua L. Colburn, Vilena Nicolet, and
Amra Hoso signing singly, as my true and lawful attorney-in-fact to:
(1) execute for and on my behalf, in my capacity as an officer and/or
director of Panbela Therapeutics, Inc. (the "Company"), Form ID or Forms 3, 4
and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934
(the "Exchange Act") and the rules and regulations promulgated thereunder and
other forms or reports on my behalf as may be required to be filed in
connection with my ownership, acquisition, or disposition of securities
of the Company, including Form 144 and Schedule 13D or Schedule 13G;
(2) do and perform any and all acts for and on my behalf, which may be
necessary or desirable to complete and execute any such Form ID, Forms 3, 4 or
5, Form 144, Schedule 13D or Schedule 13G and timely file such form with the
Securities and Exchange Commission and any stock exchange or similar authority;
and
(3) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be to my benefit,
in my best interest, or legally required of me, it being understood that the
statements executed by such attorney-in-fact on my behalf pursuant to this
Power of Attorney shall be in such form and shall contain such terms
and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.
I hereby further grant to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and
powers herein granted, as fully to all intents and purposes as I might or
could do if personally present, with full power of substitution or
revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorney-in-fact's substitute or substitutes,
shall lawfully do or cause to be done by virtue of this Power of
Attorney and the rights and powers herein granted. I herebyz
acknowledge that the foregoing attorneys-in-fact, in serving in such
capacity at my request, are not assuming, nor is the Company assuming,
any of my responsibilities to comply with Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until I am no
longer required to file Form ID or Forms 3, 4 and 5 with respect to my
holdings of and transactions in securities issued by the Company, unless
earlier revoked by me in a signed writing delivered to the foregoing
attorneys-in-fact. Notwithstanding the foregoing, if any such
attorney-in-fact hereafter ceases to be at least one of the following:
(i) a partner of Faegre Drinker Biddle & Reath LLP or
(ii) an employee of Faegre Drinker Biddle & Reath LLP, then this
Power of Attorney shall be automatically revoked solely as to
such individual, immediately upon such cessation, without
any further action on my part.
I hereby revoke all previous Powers of Attorney that have been granted
by me in connection with my reporting obligations under Section 16 of
the Exchange Act with respect to my holdings of and transactions
in securities issued by the Company.
IN WITNESS WHEREOF, I have caused this Power of Attorney to be duly
executed as of this 15th day of June 2022.
/s/ Jeffrey E. Jacob